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PPO2 > Acquired Brain Injuries > Flashcards

Acquired Brain Injuries Flashcards

1
Q

what is an acquired brain injury

A

any condition/event resulting in a sudden non-progressive, or non-degenerative change in neurological processing which can indicate

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2
Q

what are 4 categories of acquired brain injuries

A

traumatic brain injury, stroke or cerebral vascular accident, post surgical neurological complications and vestibular dysfunctions

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3
Q

what is vision rehabilitation

A

rehab of the entire visual system and focus on how visual processing impacts behavior and cognitive function

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4
Q

what does an optometrist do for brain injury patients

A

corrects refractive errors, assesses functional vision, and diagnoses ocular health issues

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5
Q

what are treatments that optometrists can do for brain injuries

A

lenses, prisms (fresnel, gottlieb, peli), low vision aids and visual rehabilitation

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6
Q

how do you place a prism on specs for a brain injury

A

base out on the eye of the side with the defect - superior or inferior not in center

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7
Q

where would you place a prism for a right hemianopsia

A

base out on the right lens

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8
Q

what things do you do differently in the exam for a brain injury

A

minimize movement around patient, keep room dim, speak clearly, take extensive case history, and notice orientation to person, place, time

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9
Q

what specific things are you going to ask a patient with a brain injury

A

diplopia, photophobia, headaches, VF cuts, balance and short/long term goals regarding specific vision symptoms

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10
Q

what do you pay special attention to during the work up

A

VF assessment - midline shift and neurological screening

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11
Q

what is visual neglect

A

cognitive deficit that refers to the unawareness of objects, people and visual stimuli presented in a visual space contralateral to the cerebral lesion

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12
Q

if a patient had a stroke to the right hemisphere, where would the neglect be

A

left visual spatial neglect

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13
Q

how is visual neglect different from VF cut

A

the patient with a VF cut is aware of their vision loss

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14
Q

what are some symptoms of visual neglect

A

alteration of egocenter (midline shift), bump into objects, skip words while reading, only eat half food on plate, lost in familiar/unfamiliar places, and groom half their face/hair

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15
Q

what are 2 tests for visual neglect

A

have patient draw a clock face and a specific time that incorporates both side of face - 9:15 or have patient do a line bisection (bisect center of each line)

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16
Q

what is a visual midline shift

A

mismatch of information and distorting of space due to disruption of ambient system

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17
Q

what are some symptoms of a visual midline shift

A

alteration of posture, difficulty with balance, hemiplegia, hemiparesis, flexion/extension difficulty, and neglect

18
Q

how can you help treat visual midline shifts

A

yoked prisms

19
Q

what is photophobia

A

extreme sensitivity to light- inducing pain

20
Q

how can you treat photophobia

A

apply tints to lenses

21
Q

what color tints are for outdoor and indoors

A

outdoors = brown/gray and indoors = blue or gray (blue is for fluorescent lights)

22
Q

how can you help treat diplopia

A

can resolve on its own or use fresnel or ground in prisms

23
Q

what exercises can help with oculomotor deficits

A

basic scanning and searching exercises: line tracing (Ann Arbor/Michigan tracking), track words while listening to book on tape, call out first and last letter on a page and create an aperture/window highlighting the text (concentrate on accuracy and speed later)

24
Q

how can you help with vergence deficits

A

stabilize vergence in primary gaze at far and near distance and facility and sustainability of fusional vergence at far and near viewing distances

25
Q

how can you help with accommodation deficits

A

work on improving the weaker aspect of focusing, build up and equalize accommodative amplitudes, and work on maintaining ability to rapidly change focus on command and sustain focus for extended periods of time

26
Q

what exercises can help with accommodation deficits

A

loose lenses/flipper - use different targets at different distances

27
Q

how can you help with visual-vestibular deficits

A

work on central- peripheral integration

28
Q

how can you help impaired visual field integrity

A

practice scanning into the blind field, teach patient to look into their blind zone and Borderzone stimulation

29
Q

what instrument is used for borderzone stimulation

A

Nova Vision Therapy System - maps edge of field and presents stimuli near border making small increases

30
Q

how many areas of the brain are involved in visual processing

A

35

31
Q

what deficits occur with oculomotor dysfunction

A

limitations of gaze, nystagmus, and speed and quality of pursuits and saccades

32
Q

what are some potential symptoms of oculomotor dysfunction

A

inability to follow objects smoothly, reading problems, skipping words, re-reading words, and word/letter reversals

33
Q

what are some deficits with binocular dysfunction

A

strabismus, muscle paresis/paralysis, convergence insufficiency, and reduced or slow fusional ability

34
Q

what are some potential symptoms of binocular dysfunction

A

head turn/tilt, diplopia, poor depth/spacial judgements, closing one eye, headaches, asthenopia, reading difficulty, tired eyes, watering, fall asleep while reading, and task avoidance

35
Q

what are some deficits with accommodative dysfunction

A

accommodative insufficiency, pseudo-myopia, and speed and quality of accommodative response

36
Q

what are some potential symptoms of accommodative dysfunction

A

blue, headaches, pain, diplopia, squinting, closing one eye, reading problems, ocular discomfort, tired/watery eyes, falling asleep while reading and task avoidance

37
Q

what are some deficits with visual-spatial/visual information processing dysfunction

A

visual-vestibular integration problems, visual-motor integration problems, difficulty understanding spacial coordination, disturbances in body image, disturbance in sustaining visual attention

38
Q

what are some symptoms with visual-spatial/visual information processing dysfunction

A

balance issues, poor distance judgement, motor coordination problems, eye-hand problems, left/right confusion, objects appear to move, agnoisa, apraxia, inattentive, recognizing faces, visual memory and writing difficulty

39
Q

what are some symptoms for VF loss/visual-spatial neglect

A

oculomotor related symptoms, difficulty locating objects, gait, balance, seeing at night, spatial insecurity, unable to drive

40
Q

what VF loss occurs with a lesion anterior to optic chiasm

A

monocular visual field loss

41
Q

what VF loss occurs with a lesion or tumor at the optic chiasm

A

bitemporal hemianopsia

PPO2 (16 decks)

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